A nurse is caring for a client who experienced a lacerated spleen and has been on bedrest for several days. The nurse auscultates decreased breath sounds in the lower lobes of both lungs. The nurse should realize that this finding is most likely an indication of which of the following conditions?

A. Notify the client's provider: This option might be considered if there are signs of postpartum hemorrhage, such as excessive bleeding, signs of shock, or a boggy uterus that does not respond to massage. However, in this scenario, the fundus is midline and firm, which indicates appropriate uterine contraction. Therefore, notifying the provider at this point may not be necessary.
B. Encourage the client to empty her bladder: Encouraging the client to empty her bladder is always important in the postpartum period, as a full bladder can impede uterine contraction. However, the presence of lochia rubra and small clots along with a midline and firm fundus suggests that uterine involution is progressing well. While encouraging the client to empty her bladder is appropriate, it may not be the priority in this situation.
C. Increase the frequency of fundal massage immediately: Fundal massage is typically performed to promote uterine involution and prevent postpartum hemorrhage. However, in this scenario, the fundus is already midline and firm, indicating adequate contraction. Increasing the frequency of fundal massage unnecessarily could cause discomfort to the client and is not indicated based on the current assessment findings.
D. Document the findings and continue to monitor the client: This is the most appropriate action at this time. The presence of lochia rubra and small clots along with a midline and firm fundus suggests that the uterus is involuting properly. Documenting the findings allows for accurate documentation of the client's condition and continued monitoring for any changes or developments. If the client's condition changes or if there are signs of postpartum hemorrhage, further action, such as notifying the provider, can be taken.

A. "My child must be free from this before returning to school": While it's important for the child to be treated and free from head lice before returning to school, this statement alone doesn't address the comprehensive measures needed to eradicate pediculosis capitis. It focuses only on the child's return to school without considering other aspects of treatment and prevention.
B. "Toys that can't be dry cleaned or washed must be thrown out": Throwing out toys that can't be dry cleaned or washed is an extreme measure and unnecessary for managing pediculosis capitis. While cleaning items that come into contact with the child's head is important, it's not necessary to dispose of toys unless they cannot be effectively cleaned.
C. "All recently used clothing, bedding, and towels must be washed in hot water": This statement indicates a thorough understanding of the teaching. Washing recently used clothing, bedding, and towels in hot water is an essential step in eliminating head lice and preventing reinfestation. Hot water helps kill lice and their eggs, reducing the risk of transmission.
D. "I will treat all the family members to be on the safe side": Treating all family members is a prudent measure to prevent the spread of head lice within the household. However, this statement alone doesn't address other important aspects of treatment and prevention, such as washing bedding and clothing. While treating family members is important, it's only one part of a comprehensive approach to managing pediculosis capitis.